Effects of remimazolam combined with sufentanil on hemodynamics during anesthetic induction in advanced-age patients with hypertension undergoing orthopedic surgery of the lower limbs：a randomized,controlled trial

Abstract Purpose This study was performed to observe the effect of remimazolam combined with sufentanil on hemodynamics during anesthetic induction in advanced-age patients with hypertension undergoing orthopedic surgery of the lower limbs. Methods This randomized controlled trial included 60 advanced-age patients with hypertension who were undergoing orthopedic surgery of the lower limbs. The patients were randomly assigned to undergo general anesthesia with either remimazolam (group R) or propofol (group P, n = 30, each group).The MAP,HR,CO,CI,SVR and pulse oxygen saturation were recorded. The disappearance time of the eyelash reflex, injection pain, hypotension, bradycardia, hiccuping, nausea and vomiting, and other adverse events were observed. Results The MAP, HR, CO, CI, and SVR were significantly higher in Group R than P at T1, T2, T3, and T4 (P < 0.05). In Group P, the MAP, HR, CO, and CI were significantly lower and the SVR was significantly higher at T1, T2, T3, and T4 than at T0 (P < 0.05). The disappearance time of the eyelash reflex was significantly longer in Group R than P, and the injection pain, hypotension, and bradycardia were significantly lower in Group R than P (P < 0.05). There was no significant difference in hiccupping or nausea and vomiting between the two groups (P > 0.05). Conclusion The combination of remimazolam and sufentanil for induction of general anesthesia produces only small hemodynamic fluctuation, maintains stability of the circulation, and has few adverse effects, making it more suitable for advanced-age patients with hypertension.